{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T01:14:08Z","timestamp":1789002848595,"version":"build-2803163510"},"reference-count":44,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2014,1,1]],"date-time":"2014-01-01T00:00:00Z","timestamp":1388534400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Investigative Medicine"],"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Autoimmunity plays an essential role in the pathogenesis of rheumatic heart disease (RHD); however, cellular mechanisms of autoimmune response are unclear. Whereas T helper 17 (T\n                      <jats:sub>H<\/jats:sub>\n                      17) and regulatory T cells (T\n                      <jats:sub>reg<\/jats:sub>\n                      ) cells share a common differentiation pathway, they play opposite roles in the immune tolerance and autoimmune diseases. Although high T\n                      <jats:sub>H<\/jats:sub>\n                      17\/T\n                      <jats:sub>reg<\/jats:sub>\n                      ratio has been shown in several autoimmune diseases, no data are available in RHD. This study investigated the balance between T\n                      <jats:sub>H<\/jats:sub>\n                      17 and T\n                      <jats:sub>reg<\/jats:sub>\n                      in rheumatic mitral valve disease (MVD).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Forty patients with rheumatic MVD and 23 control subjects were enrolled into the study. All subjects underwent clinical, electrocardiographic, and echocardiographic evaluation. The percentages of circulating T\n                      <jats:sub>H<\/jats:sub>\n                      17 and T\n                      <jats:sub>reg<\/jats:sub>\n                      cells were analyzed by flow cytometry. Serum levels of high-sensitivity C-reactive protein (hs-CRP) and cytokines were assessed by enzyme-linked immunosorbent assay.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      As compared with control subjects, rheumatic MVD patients showed significant increase in peripheral T\n                      <jats:sub>H<\/jats:sub>\n                      17 percentage, high serum levels of T\n                      <jats:sub>H<\/jats:sub>\n                      17-related cytokine interleukin 17A, and an obvious decrease in the percentage of T\n                      <jats:sub>reg<\/jats:sub>\n                      cells. T helper 17\/T\n                      <jats:sub>reg<\/jats:sub>\n                      ratio was significantly high in rheumatic MVD patients compared with control subjects ( P = 0.0001). Serum concentrations of hs-CRP in rheumatic MVD group were higher than those of the control subjects, and hs-CRP levels correlated with the T\n                      <jats:sub>H<\/jats:sub>\n                      17\/T\n                      <jats:sub>reg<\/jats:sub>\n                      ratio ( r = 0.71, P = 0.0001). Serum levels of transforming growth factor \u03b21 were increased in rheumatic MVD group compared with those of the control subjects.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      The results indicated that high T\n                      <jats:sub>H<\/jats:sub>\n                      17\/T\n                      <jats:sub>reg<\/jats:sub>\n                      ratio exists inrheumatic MVD. This imbalance may play a role in the pathogenesis, and T\n                      <jats:sub>H<\/jats:sub>\n                      17\/T\n                      <jats:sub>reg<\/jats:sub>\n                      balance may be a promising therapeutic approach in RHD.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2310\/jim.0000000000000023","type":"journal-article","created":{"date-parts":[[2016,5,11]],"date-time":"2016-05-11T09:10:57Z","timestamp":1462957857000},"page":"78-83","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":56,"title":["A Shift in the Balance of Regulatory T and T Helper 17 Cells in Rheumatic Heart Disease"],"prefix":"10.1177","volume":"62","author":[{"given":"Hatice Duygu","family":"Bas","sequence":"first","affiliation":[{"name":"Department of Cardiology, Gazi University Faculty of Medicine, Ankara, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazim","family":"Baser","sequence":"additional","affiliation":[{"name":"Cardiology Department, Ankara Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emine","family":"Yavuz","sequence":"additional","affiliation":[{"name":"Department of Immunology, Immunology Research Center, Gazi University Faculty of Medicine, Ankara, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hasan Ata","family":"Bolayir","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Gazi University Faculty of Medicine, Ankara, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Belma","family":"Yaman","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Gazi University Faculty of Medicine, Ankara, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serkan","family":"Unlu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Gazi University Faculty of Medicine, Ankara, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atiye","family":"Cengel","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Gazi University Faculty of Medicine, Ankara, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emin Umit","family":"Bagriacik","sequence":"additional","affiliation":[{"name":"Department of Immunology, Immunology Research Center, Gazi University Faculty of Medicine, Ankara, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ridvan","family":"Yalcin","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Gazi University Faculty of Medicine, Ankara, 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